Policy & Compliance
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March 18, 2025
Reg Attys Talk FTC Healthcare and Antitrust Under Ferguson
Regulatory attorneys focused on the healthcare industry aren't expecting huge changes in federal antitrust activity under new leadership at the Federal Trade Commission.
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March 18, 2025
Ohio Appeals Court Blocks Trans Care Restrictions
An Ohio state appeals court on Tuesday ruled that a portion of a state law restricting gender-affirming care for transgender youth was unconstitutional, overturning a county court judge's decision siding with the state.
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March 18, 2025
Elevance Inks $3.3M Deal To End Surgery Claim Denial Suit
Elevance has agreed to pay $3.3 million to close a suit claiming it denied coverage for a spinal surgery through employee health plans after incorrectly deeming the procedure medically unnecessary, according to a Kentucky federal court filing.
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March 18, 2025
Feds Say Wash. Hospital Can't Strike Facts From Fraud Suit
The government has accused a hospital operator in Washington state of "grasping at straws" by trying to strike inconvenient facts from the court record in a bid to defeat a False Claims Act lawsuit, a tactic prosecutors urged the court to see through and reject.
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March 18, 2025
Repeal Of Social Needs Guidance Sows Medicaid Uncertainty
A Trump administration rollback of guidance on health-related social needs may bode poorly for the future of state-federal pilot programs that provide Medicaid recipients with tools to live healthier, safer lives.
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March 18, 2025
States Oppose Term In Sandoz Price Fixing Deal With Fla.
State enforcers still locked in price-fixing litigation against generic-drugmaker Sandoz are raising objections to a cap on what they could win through settlements in Florida's recent agreement with the company, telling the Connecticut federal judge weighing approval that it would block or delay potential settlements of their own.
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March 18, 2025
Indirect Effexor Buyers Seek Approval Of $2.3M Antitrust Deal
A proposed class of indirect drug purchasers have asked a New Jersey federal judge for his initial sign-off on a $2.25 million deal with Teva Pharmaceuticals to resolve antitrust claims against the company over antidepressant and anxiety disorder treatment Effexor XR.
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March 18, 2025
Feds Reject 'Absurd' Defense In Harvard Body Parts Case
Federal prosecutors in Pennsylvania have blasted an "absurd argument" that a stolen-goods law doesn't criminalize buying and selling body parts stolen from cadavers donated to the Harvard Medical School's morgue.
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March 18, 2025
Illinois Asbestos Injury Firm Escapes 'Fraud Playbook' Suit
A Chicago federal judge on Tuesday tossed a racketeering suit an industrial pipe company brought against a "prolific" Illinois asbestos litigation law firm, finding that the pipe company failed to adequately plead that the law firm formed an "enterprise" with various clients, witnesses, co-counsel and staff.
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March 18, 2025
Minn. AG, Mayo Clinic Settle Charity Probe: 3 Things To Know
The Mayo Clinic will reform its charity care policies after an investigation by Minnesota officials found the hospital system sued its patients over medical debt even though they might have qualified for financial assistance.
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March 17, 2025
US Chamber Says FCA Qui Tam Provisions Unconstitutional
The U.S. Chamber of Commerce on Monday endorsed a legal challenge aimed at bringing down the whistleblower provisions in the False Claims Act, arguing there is a "manifest conflict between the modern FCA's qui tam provisions and Article II's text."
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March 17, 2025
Gutting USAID Threatens US Credibility, 22 Ex-Officials Say
A bipartisan group of former high-ranking national security and defense officials on Monday voiced opposition to the Trump administration's decision to dismantle the U.S. Agency for International Development, saying in an amicus brief filed in D.C. federal court that the shutdown undermines the United States' credibility while allowing China and Russia to build theirs.
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March 17, 2025
New Bills Target 'Patent Thickets' And 'Product Hopping'
A bipartisan group of senators is backing two bills it says will use the patent system to lower the price of prescription drugs, in part by targeting "patent thickets" and making "product hopping" a violation of antitrust laws.
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March 17, 2025
PBMs Hit With Antitrust Suit Over GoodRx Generics Program
A Denver pharmacy has filed a proposed class action against GoodRx, CVS and other major pharmacy benefit managers in Colorado federal court, alleging they engaged in an illegal price-fixing scheme that artificially suppressed the prices paid to independent pharmacies for reimbursement of generic drug claims.
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March 17, 2025
VA To End Medical Care For Gender Dysphoria
The U.S. Department of Veterans Affairs will stop offering medical treatments for gender dysphoria in order to comply with an executive order by President Donald Trump, the agency announced Monday.
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March 17, 2025
Full 7th Circ. Won't Revive Suit Over Late Medicaid Payments
The full Seventh Circuit has answered the "enormous question" of whether a Chicago hospital can sue the state of Illinois to force the managed-care organizations it contracts with to make timely Medicaid payments, concluding the hospital doesn't have a federal right to prompt payments for fear of turning federal trial courts into "de facto Medicaid claims processors."
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March 17, 2025
May Trial Set For Ex-Conn. Official's New Corruption Charges
A Connecticut federal judge said Monday that former Constitution State budget official Konstantinos Diamantis and ex-lawmaker Christopher Ziogas will go to trial on May 7 for claims they respectively took and paid bribes to stop a state audit of Ziogas' fiancée, who has admitted to healthcare fraud.
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March 17, 2025
House Panel Probes Medical Residency Antitrust Exemption
The chair of the House Judiciary Committee's antitrust panel is looking into whether to do away with an antitrust exemption Congress granted over 20 years ago to the medical residency matching system, which the congressman said could be harming new doctors and even patients.
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March 17, 2025
Houston Midwife Arrested In Texas' 1st Criminal Abortion Case
A Houston-area midwife has been arrested after an investigation by the Texas attorney general's office for allegedly providing illegal abortions, Attorney General Ken Paxton announced Monday, the first such criminal charges brought since the state issued its near-total abortion ban.
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March 17, 2025
Feds Defend Prof's Deportation As Arnold & Porter Withdraws
Government lawyers told a Massachusetts federal judge Monday they did not disobey a court order halting the deportation of a Brown University doctor and professor with an H-1B visa, as a team of Arnold & Porter Kaye Scholer LLP lawyers who lobbed that claim abruptly withdrew from the case.
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March 17, 2025
Seeger Weiss Atty Tapped To Lead Depo-Provera Plaintiffs
A Florida federal judge on Sunday selected Christopher Seeger of Seeger Weiss LLP to lead the team representing plaintiffs in the multidistrict litigation claiming Pfizer Inc. failed to adequately warn patients and doctors about the risk of brain tumors associated with the hormonal contraceptive drug Depo-Provera.
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March 14, 2025
Ga. Panel Says COVID-Era Legal Shield Blocks Amputee's Suit
A divided Georgia Court of Appeals on Friday said a trial court should have dismissed a wrongful amputation suit against a Marietta hospital, holding that the patient who lost his right leg after being admitted for COVID-19 symptoms could not beat the legal immunity granted to the hospital by a pandemic-era state law.
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March 14, 2025
Md. Judge Joins Calif. In Reversing Federal Workers' Firing
A Maryland federal judge has ordered the reinstatement of thousands of probationary employees who were abruptly fired from 18 federal agencies, saying the Trump administration's lack of required notice left states "scrambling" to pick up the pieces.
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March 14, 2025
NC Ex-Doctor Gets 2.5 Years For Drug Test Billing Scheme
A 72-year-old doctor in North Carolina was sentenced Friday to two and a half years in prison and ordered to hand over $2 million in restitution for a fraudulent billing scheme involving medically unnecessary drug tests, prosecutors said.
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March 14, 2025
FTC Urges 8th Circ. Not To Pause Insulin Pricing Case
The Federal Trade Commission has urged the Eighth Circuit not to pause its in-house case accusing Caremark Rx, Express Scripts and OptumRx of artificially inflating insulin prices, telling the appeals court the pharmacy benefit managers have no chance of winning on their constitutional claims.

HHS Comment Reversal Sets Stage For Quick Policy Changes
The sudden reversal at the U.S. Department of Health and Human Services of a longstanding commitment to robust public engagement clears the way for fast-paced changes to Medicaid and other massive programs, putting more pressure on compliance officers and sending more lobbying work behind closed doors.

HHS Cuts Hit Attys Tackling Medicare Appeals Backlog
The Department of Health and Human Services is terminating more than a dozen attorneys charged with reducing a massive backlog of Medicare appeals at an internal administrative board. The cuts may slow an already cumbersome administrative process.

CDC Layoffs Provoke Legal Questions, Worker Anxiety
Workers and experts with insight into the Centers for Disease Control and Prevention have described the roughly 750 layoffs at the agency as chaotic and confusing, and question Trump's legal authority to unilaterally change the agency. They are also concerned it will impact the agency’s ability to investigate disease outbreaks.
Expert Analysis
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What Trump's Order Means For The Legal Status Of IVF
An executive order signed by President Donald Trump last month signals the administration's potential intention to increase protections for in vitro fertilization services, though more concrete actions would be needed to resolve the current uncertainty around IVF access or bring about a binding legal change, says Jeanne Vance at Weintraub Tobin.
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Mitigating Tariff Risks For Healthcare In US And Canada
Healthcare stakeholders should take steps to evaluate the impact of cross-border tariffs, as the historically strong ties between Canada and the U.S. demonstrate the potential for real disruption and harm to the healthcare industry in both countries, say attorneys at Norton Rose.
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What's At Stake In High Court Transgender Care Suit
The outcome of U.S. v. Skrmetti will have critical implications for the rights of transgender youth and their access to gender-affirming care, and will likely affect other areas of law and policy involving transgender individuals, including education, employment, healthcare and civil rights, say attorneys at ArentFox Schiff.
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6 Laws Transforming Calif.'s Health Regulatory Framework
Attorneys at Hooper Lundy discuss a number of new California laws that raise pressing issues for independent physicians and small practice groups, ranging from the use of artificial intelligence to wage standards for healthcare employees.
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Anticipating Calif. Oversight Of PE Participation In Healthcare
A new bill recently introduced in the California Senate revives last year's attempt to increase oversight of healthcare transactions involving private equity groups and hedge funds, meaning that attorneys may soon need to assess the compliance status of existing management relationships and consider modifying contract terms, says Andrew Demetriou at Husch Blackwell.
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Considering The Future Of AI Regulation On Health Sector
As Texas looks to become the next state to pass a comprehensive law regulating artificial intelligence, the healthcare industry should consider how AI regulation will continue to evolve in the U.S. and how industry members can keep up with compliance considerations, say attorneys at Kirkland & Ellis.
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What To Expect From 'Make America Healthy Again' Actions
The Make America Healthy Again Commission recently established by President Donald Trump and chaired by Robert F. Kennedy Jr. will potentially bring energy and attention to important public health topics, and stakeholders should be aware of pathways for sharing their input and proactively informing proceedings, says Nicholas Manetto at Faegre Drinker.
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How Citizen Petitions Have Affected Drug Competition
In light of recent citizen petitions and proposed legislation regulating such petitions, Omar Robles at Managing Health analyzes the statistics of the extent to which citizen petitions have been filed, and to what extent they have delayed competition in prescription pharmaceuticals.
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Drug Kickback Ruling Will Make FCA Liability Harder To Prove
The First Circuit's ruling in U.S. v. Regeneron Pharmaceuticals, requiring the government to prove but-for causation to establish False Claims Act liability based on violations of the Anti-Kickback Statute, raises the bar for FCA enforcement and deepens a circuit split that the U.S. Supreme Court may need to resolve, say attorneys at Baker Donelson.
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Assessing PE Risk After Mass. False Claims Act Amendments
A law recently passed in Massachusetts amends the commonwealth's False Claims Act by dramatically expanding potential liability for private equity firms and investors, underscoring the importance of robust diligence and risk assessments for private equity firms conducting transactions in the commonwealth, say attorneys at Gibson Dunn.
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What Trump Actions Mean For Federal Research Funding
New guidance from the National Institutes of Health represents a massive policy shift regarding federal funding for researchers at institutions of higher education, contributing to a perfect storm of significant resource shortfalls in upcoming years, say attorneys at Arnold & Porter.
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A Look At Healthcare Transaction Oversight In Oregon
Understanding Oregon's enforcement authority and its impact on proposed transactions last year provides a road map to the state's plans to strengthen its processes this year, though enforcement could be challenged by ongoing litigation, say attorneys at Ropes & Gray.
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Rethinking 'No Comment' For Clients Facing Public Crises
“No comment” is no longer a cost-free or even a viable public communications strategy for companies in crisis, and counsel must tailor their guidance based on a variety of competing factors to help clients emerge successfully, says Robert Bowers at Moore & Van Allen.